Source:http://linkedlifedata.com/resource/pubmed/id/12603213
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
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| pubmed:dateCreated |
2003-2-26
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| pubmed:abstractText |
New onset diabetes is a major complication after kidney transplantation. However, the incidence, risk factors and clinical relevance of post-transplant diabetes mellitus (PTDM) vary among reports from single-center observational studies and clinical trials. Using data from the United Renal Data System we identified 11 659 Medicare beneficiaries who received their first kidney transplant in 1996-2000. The cumulative incidence of PTDM was 9.1% (95% confidence interval = 8.6-9.7%), 16.0% (15.3-16.7%), and 24.0% (23.1-24.9%) at 3, 12, and 36 months post-transplant, respectively. Using Cox's proportional hazards analysis, risk factors for PTDM included age, African American race (relative risk = 1.68, range: 1.52-1.85, p < 0.0001), Hispanic ethnicity (1.35, range: 1.19-1.54, p < 0.0001), male donor (1.12, range: 1.03-1.21, p = 0.0090), increasing HLA mismatches, hepatitis C infection (1.33, range: 1.15-1.55, p < 0.0001), body mass index >or=30 kg/m2 (1.73, range: 1.57-1.90, p < 0.0001), and the use of tacrolimus as the initial maintenance immunosuppressive medication (1.53, range: 1.29-1.81, p < 0.0001). Factors that reduced the risk for PTDM included the use of mycophenolate mofetil, azathioprine, younger recipient age, glomerulonephritis as a cause of kidney failure, and a college education. As a time-dependent covariate in Cox analyses that also included multiple other risk factors, PTDM was associated with increased graft failure (1.63, 1.46-1.84, p < 0.0001), death-censored graft failure (1.46, 1.25-1.70, p < 0.0001), and mortality (1.87, 1.60-2.18, p < 0.0001). We conclude that high incidences of PTDM are associated with the type of initial maintenance immunosuppression, race, ethnicity, obesity and hepatitis C infection. It is a strong, independent predictor of graft failure and mortality. Efforts should be made to minimize the risk of this important complication.
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| pubmed:commentsCorrections | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Feb
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| pubmed:issn |
1600-6135
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
3
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
178-85
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| pubmed:dateRevised |
2007-2-14
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| pubmed:meshHeading |
pubmed-meshheading:12603213-Adolescent,
pubmed-meshheading:12603213-Adult,
pubmed-meshheading:12603213-African Continental Ancestry Group,
pubmed-meshheading:12603213-Age Distribution,
pubmed-meshheading:12603213-Body Mass Index,
pubmed-meshheading:12603213-Child,
pubmed-meshheading:12603213-Child, Preschool,
pubmed-meshheading:12603213-Diabetes Mellitus,
pubmed-meshheading:12603213-Educational Status,
pubmed-meshheading:12603213-European Continental Ancestry Group,
pubmed-meshheading:12603213-Female,
pubmed-meshheading:12603213-Graft Rejection,
pubmed-meshheading:12603213-HLA Antigens,
pubmed-meshheading:12603213-Hepatitis C Antibodies,
pubmed-meshheading:12603213-Humans,
pubmed-meshheading:12603213-Immunosuppression,
pubmed-meshheading:12603213-Incidence,
pubmed-meshheading:12603213-Infant,
pubmed-meshheading:12603213-Infant, Newborn,
pubmed-meshheading:12603213-Kidney Transplantation,
pubmed-meshheading:12603213-Male,
pubmed-meshheading:12603213-Medicare,
pubmed-meshheading:12603213-Middle Aged,
pubmed-meshheading:12603213-Risk Factors,
pubmed-meshheading:12603213-Sex Distribution,
pubmed-meshheading:12603213-Survival Rate,
pubmed-meshheading:12603213-United States
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| pubmed:year |
2003
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| pubmed:articleTitle |
Diabetes mellitus after kidney transplantation in the United States.
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| pubmed:affiliation |
The United States Renal Data System Coordinating Center, Minneapolis, MN, USA. kassi001@umn.edu
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| pubmed:publicationType |
Journal Article
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